Healthcare Provider Details

I. General information

NPI: 1467978320
Provider Name (Legal Business Name): NICOLE E TAYLOR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14416 W MEEKER BLVD STE 301.
SUN CITY WEST AZ
85375
US

IV. Provider business mailing address

14416 W MEEKER BLVD STE 301.
SUN CITY WEST AZ
85375
US

V. Phone/Fax

Practice location:
  • Phone: 480-256-6444
  • Fax: 480-256-3682
Mailing address:
  • Phone: 480-256-6444
  • Fax: 480-256-3682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number6827
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: